My grandfather, who worked as a cook for several years, had a hard time eating out. “Once you see what happens in a restaurant kitchen,” he would say, “you can’t unsee it.” He would offer a few cringe-worthy examples and then go silent, as if to ensure there would be no distractions while my imagination ran wild.

I think of his words often now that I’ve seen the “kitchen” of our healthcare system. The medical field is awe-inspiring and filled with fantastic practitioners, but it can also be chaotic and deeply flawed. 

Knowing what goes on behind closed doors has empowered me to navigate my own care. So, when I learned this week that someone I love needs surgery, I kicked into gear to help her find a top-notch doctor who would keep her safe. Read on to learn how you can do the same.

Why it matters

A sobering statistic: medical error is one of the top 10 causes of death in the U.S., taking approximately 250,000 lives per year.

In one large survey, 10% of doctors reported that they made a major medical mistake in the last three months. This is just one piece of a much bigger story: medicine operates within a very flawed system, making it easy for errors to happen.

What you can do

I am immensely grateful for healthcare: no one in my immediate family would be alive without it. But I am also vigilant, proactive, and street smart. You should be too. Picking a doctor is an incredible act of vulnerability and trust. Here are four of my favorite “hacks” for getting the best care: 

Vet your doctors

If you’ve ever stayed in an AirBnB, you understand the importance of researching your options. When it comes to your doctors, here are some good places to start:

• Check licensing and disciplinary actions here or here

• Search best hospitals by specialty and procedure here

• Ask medical professionals you trust for input and referrals

If you’re making an especially important care decision or just want to know more:

• Learn what financial relationships your doctors and hospitals have with drug and med device companies here and here 

• Know where your doctor was trained (search top programs by specialty here)

• Compare physician reviews here and here

Get a second opinion

Trusting a single doctor’s plan is like buying a car from a dealer with only one vehicle on the lot. It might be exactly the right car for you. Or, you might end up in a station wagon when you should be driving a coupe.

The research is clear: getting a second opinion will reduce your likelihood of diagnostic errors, overtreatment, and more. A study from Mayo Clinic found that 88% of cancer patients who got a second opinion received a new or altered diagnosis that changed their care plan.

Good doctors welcome second (and third) opinions and often proactively seek input from their colleagues for complex cases.

Be one of many

The more frequently your doctor does your procedure, the safer it will be.

Countless studies have found that surgeons and hospitals with high procedure volumes have better outcomes for those procedures. For example, a review of GI cancer surgeries across many hospitals found that each doubling in case volume decreased the odds of surgery-related death by 10-20%.

The relationship between safety and volume is so compelling that policy-makers have called for providers to stop doing procedures if they perform them infrequently. 

Look for doctors practicing full-time who do the same few procedures over and over again. These will usually be sub-specialists with narrow areas of focus (e.g. an orthopedic surgeon who only does the foot and ankle). The best way to figure out their case volume? Ask them.

Make friends with the receptionist (and everyone else)

Receptionists spend all day on the front lines of patient care fielding calls about pain, complications, and follow-up visits. They — and the rest of the office — see a physician’s track record unfold in real time.

Every interaction you have with the team is an opportunity to learn from the people who really know. When I’m getting my vitals taken I ask questions like, “How long have you worked here?” “Do you like it?” “Which doctor would you recommend?” “Are they good?” The answers carry tone and body language that almost always tell a story.  

While we’re on the topic of questions: trust your voice and don’t ever be afraid to speak up or ask anyone (including your doctor) about anything.

Here’s to a week of good restaurants, great doctors, and kitchen tables surrounded by the people you love.

Dr. Lauren Kelley-Chew
@drkelleychew

P.S. These newsletters are going to be biweekly instead of weekly for a while - look out for the next one in two weeks!

I’m a Stanford and Penn-trained MD and health tech founder with over a decade working on health optimization in Silicon Valley. Biohacking for the Rest of Us is my answer to medical elitism – I want all people to have access to cutting-edge science that can dramatically improve their health.

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